Excerpt: Ralph Lauren's Niece on Eating Disorders

After battling anorexia and bulimia for years, Jenny Lauren — the niece of fashion icon Ralph Lauren — began experiencing a new illness that litterally brought her to her knees. Meanwhile, a series of doctors told her it was all in her head.

In her new book, Homesick, Lauren gives a first-person account of her journey to find the cause of her paralyzing illness and how it related to her lifelong battle with food and her own body image.

Chapter 1: Twitch

This twitch is driving me crazy. It's 1997, I am twenty-four years old, and for a year I have been in physical discomfort. That is 365 days with my butt twitching and an inability to contract my gluteus maximus muscles. Three hundred and sixty-five days with bugs up my a--, 365 days of wanting to jump out the window, 365 days watching the entire lower half of my body turn into jelly and atrophy. This is a sick joke.

Now, understand, it is with these muscles that women often feel sexy. The tight squeeze, the swaying of hip to hip, the alignment of the pelvis and the flattened stomach are what gives a woman so much strength to conquer the day. Losing this sensation is basically losing my connection to any kind of sensuality. So it doesn't surprise me that the depression I've often suffered from has become stronger and more unbearable this past year. Of course, this darkness, my old and dear friend, has led to the recurrence of my bulimic symptoms and to the deterioration of my emotional self.

You might say, especially if you are a psychiatrist, that it's my emotional fears, depression, feelings about my sexuality, past disappointments, and all that crap that have caused my building to collapse. I will not deny this. My coping skills are far worse than they were, but after a year (and, yes, I am as bored with this as my world-famous neurologist suggested I ought to be), I am at my wit's end. I'm trying so hard not to lose my mind, but I'm very aware that my power to intellectualize and make any sense of this is descending rapidly. I've tried to become as spiritual as possible; I've always believed in the mystical and magical journey through life, but after such pain, I need a tangible answer. I used to be able to heal myself from my depression. I learned how to use my body to ward it off, with vigorous runs, enlightened yoga, and techno-electric-charged race walks. Only, now I can't do any of that. And without that, my mind is not getting enough juice, and my creative soul, the one that carries the nervous depression and adrenaline out of me, is utterly blocked.

It was the same when I painted. I want to paint again, but that, too, is locked within my ailing body. I need to dance while I move the paintbrush, or simply feel the energy flowing throughout my body onto the canvas. I studied ballet for thirteen years. The mirrors, the leotards, all of it had an impact on my self-esteem. I had to stop in my last year of high school. I thought I'd never find anything as fulfilling. When I began to paint I was relieved. I was able to merge these two passions. Music or silence set the backdrop as I moved my body to the rhythm of my strokes, to the colors I saw and heard, and to the composition I was creating. I was using a freestyle improvisation. My gestures, my actions, and my inspiration came most deeply from my pelvis, deeply from my core. But now thinking about painting depresses me because I no longer have the energy to get downtown to my studio, let alone paint. Some osteopath actually said that I had no chi.

It's these painful twitches, though — they're absolutely maddening — and in the most demoralizing place. Of course the twitches are not in my eye, not in my shoulder, but in my a--hole. And they just keep on pulsing and breathing constantly. It's quite the symphony, with a wonderful crescendo. Great large and climactic twitches fizzle into small fluttering twitches that keep me gripping my thighs for hours. It's like there is a huge monster grabbing me between my legs. I've been telling the doctors that I think this actually all began in my stomach, that it's gotta be a digestive problem.

After I eat, even the tiniest of meals, a sucking candy or a rice cake, for God's sake, my stomach begins to fill up with air. I begin to choke and the food just doesn't want to go down. It stays lodged in my chest and flows back up into my throat. Then, every sensation, especially an overwhelming sense of muscle weakness, becomes pronounced.

Ugh, and taking a sh-- (vulgar no matter how you put it) is like giving birth, with the baby's head getting stuck for hours. I even have to stand and massage my stomach as I go, just to make things move. But then the sensation is always there, singing its lullaby or rock music all freakin' day long. Me and my twitch.

I can't exercise at all, can't even walk comfortably. The other day I taped myself up to see if it would help me run. I thought it might make my buttocks feel stronger and help me forget the twitch a little if my cheeks were pushed tighter together. I wrapped a large piece of masking tape around my cheeks as if it were a belt that kept them squeezed together, and I ran. God, how I need to sweat and pant. But I had to keep stopping to redo the tape because it wouldn't stay stuck to my sweats. Then I just gave up because it also made my hamstrings burn and ache. I had to limp from the reservoir in Central Park to Fifth Avenue to hail a cab. I was afraid I was going to have to ask my doorman to carry me upstairs to my apartment.

All year I've begged my internist, Dr. W (for Dr. Worthless), to make this stop, to find the cause. It has taken him months to take me seriously. When I first went to see him last summer, he reasoned that I was too young to be put through a series of medical tests, and he attributed my discomfort to stress. So I carried on with my life, trying to move through the days like a machine. I painted at my studio, worked at a nonprofit art organization, and scouted for beautiful/eccentric homes for a well-known design magazine. Okay, maybe it'll go away, maybe it's nerves, I thought.

The problem, though, was that I was depressed and tired all the time, and then the physical symptoms became worse. It was getting harder and harder to leave the house. I would wake up, attempt to go to the bathroom, and then the twitch would just take over. Forget the studio. Forget work. Forget seeing friends. Forget everything.

I would panic most mornings and rush up to 87th Street and Park and sit and wait in Dr. W's office, sometimes for hours, to see him. As I sat there holding my breath and clenching my legs together to stop the twitch, I'd rummage through the pile of magazines, flipping through all the fashion ads. Oh, there's Uncle Ralph with his two dogs in a Purple Label ad. Whadda ya know, there he is again. Not his face but a Ralph Lauren fragrance ad with a young beautiful couple wrapped in velvet and in love. The good life, huh? … things to aspire to. Reminding me of everything I hated, everything I loved, everything I wished I could be … but that was then. Look at me now. By the time Dr. W called me into his office, I had finished skimming the magazines from the late eighties, with Paulina and Christie Brinkley splashed all over them, and gotten through the nineties, with enough of Crawford, Turlington, and the fashion world up my nose.

Dr. W aggravates the living sh-- out of me. He listens, takes notes, and then speaks to me in his calm, methodical, and patronizing style. He has been my parents' internist forever, and they have great confidence in him. Six years earlier, when my father suffered a subarachnoid hemorrhage and was lying in bed in severe pain during recovery, it was Dr. W who found the phlebitis in his lung and leg that could have killed him. My dad was rushed into surgery on Thanksgiving Day as I shoved hospital cafeteria turkey and cranberry sauce into my mouth. I know I owe him a lot for saving my dad's life, but my confidence in him helping me is fading. He has never been able to provide relief.

Everything is always fine; he says my blood is good and I don't have hemorrhoids. He suggested I watch my diet, give up acidic and gassy sugar-free foods, and come back if I didn't feel better. How come he can't make it stop? He's a doctor for goodness' sake!

After six months of this, Dr. W starts to shift his position ever so slightly. He gives me a sigmoidoscopy, a test where they shove a scope up the lower part of the colon to take a picture of what's going on inside and they look for tumors or obstructions. It shows nothing, so he sends me to other gastroenterologists. Dr. D is a specialist who is known for a unique device he uses. It can measure the fluttering and spasms of my rectum. I've now visited him and his device five times. I have a ritual: I wait on the corner of Central Park West drinking coffee and watching the gorgeous guys go Rollerblading into the park. When the spasms get really intense, I rush to his office so he can stick this thing in my butt and see what I'm talking about. Each time he has said, "Well, they certainly exist, but I'm not sure why."

Dr. W finally gives me an esophagoscopy, which shows that I have an irritated esophagus and stomach lining (they call it a hiatal hernia), a symptom common to bulimics. But that only explains some of my discomfort, like the choking sensation and the acid reflux, and not the twitch or the overall muscle malaise. W's diagnosis doesn't stop me from continuing to vomit a few times a week even now. Sometimes I convince myself that purging will stop the twitching. As if I could only just vomit up the alien between my legs everything would be fine. Then, two months ago, he gave me two colonoscopies (these evaluate the entire colon) as well as a barium series (X-rays taken after digesting radioactive dye). Took him long enough.

The barium series showed that I have a dilated small intestine, which is evidence that something else must be going on. But Dr. W can't figure out what it's from. All year he prescribed various medications...Propulsid, Levbid, Prilosec...so many meds I can't keep track, but they've warped my body even more. Now I have glycerin suppositories to stick up my a-- to calm the spasms, and I use them frequently, praying they'll do something, but they don't. Even with these medications, I can feel the limpness in the lower half of my body, my tummy drooping, my thighs turning to mush. I can barely stand up. How can this not be some major disease?

I have questioned everything. Is this PMS, hormonal? I went to see an endocrinologist, who said that some of my fatigue and symptoms might be because I have low estrogen levels. She suggested I go on hormone-replacement pills. No way. I didn't believe this was the problem. Anybody with a continuous twitch in the a-- would get exhausted. That in itself probably caused these severely depressed hormones. Then my kinesiologist said my adrenal glands were definitely shot from all the pain. So last year I tried to address the hormone issue and took progesterone to bring on my period, but I got even more whacked. I just sat in the studio for hours staring at my blank canvases.

Two months ago I went to an acupuncturist, who also suggested that my sensations might be because I never get my period. Needles were placed all over my body. I tried to do what he suggested, to focus my energy on my pelvis "smiling." I was so tense that I couldn't even enjoy this narcissistic candlelit ritual. It didn't work. I loved him, though. I mean, at least he heard me. He thought it was my spleen or liver and had me taking about twenty-four herbs a day for a month. Trust me, any bit of Jenny that was left has been washed away with those strange, crazy herbs. Since then, my eyes and the lower part of my cranium have been twitching too, and I feel spacey all the time. My other daily ritual is hauling myself up to Barnes & Noble to read up on my symptoms. I've read about cancer, connective tissue disease, the candida yeast syndrome. I've checked for parasites and have had five tests for Lyme disease. At one point I even believed the mercury of my fillings could have been the cause. As I sit in the bookstore I wonder who else has come in that day to solve their own puzzle, who else is forced to diagnose themselves, who else is as desperate as I am for relief.

Eastern, western medicine … who the hell knows anymore. I've been to chiropractors, kinesiologists, massage therapists, along with doctors with Harvard MDs on the wall … those arrogant f---s who just take notes and stare at me like I'm nuts. Meanwhile, I keep bingeing on chocolate. I'm like the person with lung cancer who keeps on smoking.

Excerpted from Homesick by Jenny Lauren, copyright © 2004, Atria Books.